Rapporti ISTISAN 09/49 ISTITUTO SUPERIORE DI SANITÀ Ageing ...

Rapporti ISTISAN 09/49
prevention, as regards services too, of the institutions and the policies focused on the protection of
health in a wide sense. Professionals working in the field of help, within an ecological-systemic
perspective, become “facilitators” of the psycho-physical wellbeing of the elderly and, at the same
time, “mediators” of the culture of wellbeing within the different contexts of social interaction:
with the task of making resources emerge and exploiting them, of fostering propulsive dynamics
and promoting the point of view of wellbeing and psychological autonomy. In this perspective the
condition of wellbeing in general can be improved through a fundamental work networking and
involvement of the different formal and informal resources present on the territory envisaging the
active involvement of the elderly and operators. Thanks to their activities, even and above all the
free and spontaneous ones, it is possible to let concrete needs emerge, to offer a wider range of
responses, to understand the meaning of discrimination or discomfort from more points of view, to
offer a human and relational approach suitable for giving dignity back to people and to offer
further complementary responses to be added to those already given by professional services. The
envisaged intervention is then based on a model of educational and cultural model focused on the
person: on personal and relational resources. A model which considers the elderly active and
protagonists in a society which can still consider them as a resource for the different generations to
which they relate themselves: a model focused on the involvement of social and health operators
together with the elderly in the construction of a new life culture and a healthy ageing. The
success of the individual within the community and his/her wellbeing is the priority goal in each
degree and level of the world of adult’s education and training, both formal one (from the school
to professional training up to university) and informal or non-formal one (from study circles to
schools and popular universities). The culture of the competent development during the whole
lifespan helps people to manage the changes of their life cycle, more efficiently and peacefully.
One of the most difficult questions in the training of operators working with the elderly regards
the link between professionalism and social competencies and professionalism and medical-health
competencies. From one side the training of health roles seems to be strongly characterised by the
specific medical-geriatric dimension, on the other side that of social operators is less focused on
the “health” side of the question. In some cases the presence of psychologists or sociologists is
envisaged, but such presence results to be strongly marginal if compared with the whole approach.
If today the social-psychological and the medical-health fields result to be so poorly
interconnected that even training approaches result to be quite apart from each other, such
separation seems even more to be less acceptable. From one side there is the consciousness of the
connection existing between health and social-family conditions in causing the occurrence of
situations of need and/or specific demands of support regarding services, on the other side their
responses to needs must take into account the whole of the existing resources (health, social,
public and private resources). It then becomes more and more important to identify areas of
overlapping of the approach procedures to the elderly’s conditions and then to specific knowledge.
An example of training addressed to social-health operators according to a holistic intervention
perspective on the elderly is presented with the VATO training package (see
http://www.kam.fi/vato/index.html). Such training is above all focused on the functional abilities
of the elderly, resorting to a gerontological approach based on the functional vision of health.
According to such gerontological approach, the functional ability, the performance and health are
resources to be absolutely identified, enhanced, supported and promoted in terms of development.
To evaluate functional ability and to face daily life results it is more important than focusing the
attention on disturbances, diseases and the limits typical of the elderly. One of the main goals of
operators is that of facilitating autonomy among the elderly, as regards the daily management of
their life: the elderly must be able to take care of themselves, to cope with daily problems and to
represent a resource for their society. The support of the elderly’s functional ability should derive
from his ideals and concrete needs and the main function of operators should be that of
40